Descriptive Epidemiology of Gastrointestinal Cancers: Results from National Cancer Registry Programme,India

Purpose: This study aims to determine the incidence, histology, clinical extent of disease, and trends of gastrointestinal (GI) cancers in India. Methods: GI cancer cases diagnosed between 2012-2016 from 28 Population-Based Cancer Registries and 58 Hospital Based Cancer Registries under the National Cancer Registry Programme were included. Crude incidence rate and age-standardized incidence rates (AARs) were calculated. Joinpoint regression program, 4.0.1 was used for trend analysis for data from 1982 to 2016, and a P-value of <<0.05 was considered statistically significant. Results: GI cancers’ occurrence was more common among men (60.5%) than in women (39.5%). The incidence of GI cancer was highest in India’s northeast region, Aizawl district (AAR 126.9) among males, and in Papumpare district (AAR 75.9) among females. The commonest cancer among men was cancer of the esophagus (28.2%), followed by stomach cancer (21%) and rectum cancer (14.3%). Among women, cancer of the esophagus (25.7%), gallbladder (23.8%), stomach (14.8%), and rectum (14.6%) were common. Adenocarcinoma (57.83%) was the commonest type of GI tumors, followed by Squamous Cell neoplasms (25.99%). Majority of the GI cancers presented at the locoregional stage, but cancer of the gall bladder and pancreas presented at advanced stages. A rising trend for cancers of the colon, rectum, liver, gall bladder, pancreas was seen, while a declining trend was observed for stomach and oesophageal cancer. Conclusion: Our study highlights an increasing magnitude of GI cancers across different regions of India. Cancer registries form an essential tool for surveillance of GI cancers thus guiding prevention, early detection, and control programs.     

Cancer incidence in eastern Libya: the first report from the Benghazi Cancer Registry, 2003

Cancer registration in Northern Africa is still limited and, until now, there have been no population-based data available for Libya. In this paper, we present the first data collected and analyzed by the Benghazi Cancer Registry. Registration was carried out by active data collection; the registry staff routinely visited all hospitals and pathological laboratories in eastern Libya (1.6 million inhabitants) and collected information from all death registration offices. A huge archive of prevalent cases was established before the 2003 data were collected. A total of 997 cases of primary cancers were registered among residents in 2003. The world age-standardized incidence rate for all sites combined (except nonmelanoma skin) was 118 per 100,000 for men and 95 per 100,000 for women. The most frequently diagnosed malignancies in males were lung cancer (19%) and colorectal cancer (10%), followed by cancers of the head and neck (9%) and bladder (9%). Among females, they were breast cancer (26%), cancer of the colon and rectum (9%), uterus (7%) and non-Hodgkin lymphoma (5%). Our study provides data on cancer incidence in eastern Libya, and confirms that cancer incidence is much lower than in western countries. Moreover, observed patterns indicate that the incidence of many cancers, including those of the lung, breast, colon, rectum and bladder is quite different from previous estimates based on the data available from the neighboring countries.     

Cancer incidence and cancer control in Mongolia: Results from the National Cancer Registry 2008–12

Mongolia has a high burden from noncommunicable diseases, with cancer now the second leading cause of mortality. Given the paucity of situation analyses from the country, this study reports cancer data based on new cases 2008–12 from the National Cancer Registry of Mongolia covering the entire population (2.87 million). New cancer cases of 21,564 were diagnosed over the 5‐year period, with a slight predominance of cases (52%) in men. Liver cancer was the leading cancer site in both sexes (ASRs of 114.7 and 74.6 per 100,000 males and females), and responsible for almost two‐fifths of all cancer diagnoses, followed by cancers of stomach, lung and oesophagus in men and cervix, stomach and oesophagus in women. The cumulative risk of incidence for all cancers (27.7% and 20.8% in men and women, respectively) positions Mongolia above China (20.2% and 13.3%), below the United States (34.1% and 28.5%) and similar to Russia (26.1% and 19.1%). These figures shed light on the considerable magnitude of cancer in the country and the large fraction of cancers that can be prevented by lifestyle modifications and vaccine implementation. An expansion of activities of the cancer registry and the continued development of research are necessary steps in support of national cancer control planning in Mongolia.     

Impact of New Standardized Population for Estimating Cancer Incidence in Indian Context- an Analysis from National Cancer Registry Programme (NCRP)

Objective: Standardization adjusts for variations in population age-distribution and provides a summary measure for the comparison of populations and comparisons of time-trends in population. Globally, several standard population were used by many countries for comparison of rates. Segi World Standard Population (WSP) is suitable for international comparison. However, national standard population would be more appropriate for Intra-national comparison as the standard should be similar to the population of interest. This study aimed to develop Indian Standard Population (ISP) for estimating Age Adjusted Rate (AAR) and, to understand the outcome on the cancer incidence rate using ISP in Population Based Cancer Registries (PBCRs). Methods: The Indian Standard Population was estimated based on the average age structure of three Censuses (1991,2001 and 2011). Age Adjusted Rate has been estimated using two standard populations of WSP and ISP for magnitude of change and comparison between 15 PBCRs in India. Results: The implementation of ISP led to overall 20% reduction in AAR for all sites of cancers in both sexes and minor relative changes in the ranking among PBCRs. Time trends in cancer incidence rate showed same temporal pattern curve using both ISP and WSP, AARs. Conclusion: The ISP would be more representative of the age-structure of Indian registries population and this would give more realistic comparison across the different PBCRs in India.     

An Independent Survey to Assess Completeness of Registration: Population Based Cancer Registry,Chennai, India

Cancer registration in the population based cancer registry (PBCR), Chennai, India, is carried out by activemethods. It undertakes re-screening of cases in government hospitals and Cancer Institute (WIA), trace back deathcertificate notifications and collect information on all the deaths, irrespective of the stated cause on the deathcertificate, occurring in the registry area routinely to reduce the under-registration of incident cancer cases andassociated mortality. The completeness of registration during 1982-95 was assessed by conducting an independentsurvey in randomly selected areas in Chennai. The total number of households covered in the survey was 7737 andwere collected which constituted 1% of the Chennai city population. The response rate to the survey was 96%. Atotal of 42,502 incident cancer cases were registered in Chennai PBCR during 1982-95. The total number of cancercases that were already registered in PBCR from the survey area during 1982-95 was 208. Out of 208 cases, 91 (44%)were identified in the survey; the families of the remaining 117 had migrated out of the surveyed area. Two newcancer cases hitherto unregistered in the PBCR during 1982-95 were identified from the survey. Based on the survey,it is estimated that the completeness of cancer registration in Chennai PBCR is 96%, which is comparable to those ofother registries in the world.     

Some Epidemiological Measures of Cancer in Kuwait: National Cancer Registry Data from 2000 -2009

Introduction: Cancer is the second cause of death in Kuwaiti people after cardiovascular diseases. This studyis the first in the country to describe epidemiological measures related to cancer in this population. Methods:Data obtained from the Kuwait cancer registry included all Kuwaiti patients between years 2000-2009. Analyseswere conducted using age-specific rates, the age-standardization-direct method, 95% confidence intervals (95%CI), cumulative risk by the age of 74 years, limited-duration prevalence, mortality and forecasting to year 2029.Results: It was noted that the commonest cancer sites were colorectal with an age standardized incidence rate(ASIR) of 16.1/100,000 in males and breast (49.4/100,000) in the female population. The trend of cancer incidence(1974-2009) showed no statistically significant change. First causes of death due to cancer were female breast8(6.4-9.6)/100,000 and lung (males) 8.1/100,000 (6.6-10.0). The risk of developing cancer by the age of 74 was13.4% (1/8) and 14.3% (1/7) in males and females respectively, and the risk of dying from cancer in the sameage group was 1/17 and 1/23. By the end of 2009, prevalent cases represented 0.52% of the Kuwaiti population.In the year 2029, the total number of cancer cases is expected to reach 1200 cases compared to 889 cases in2009. Conclusions and recommendations: The most common cancers in Kuwait (breast, colorectal and lung)are largely preventable. Prompt and effective interventional prevention programs that vigorously involve diet,anti-smoking and physical activity for both sexes are urgently required.     

Cancer Incidence and Mortality: District Cancer Registry,Trivandrum, South India

Background: Cancer is emerging as a major cause of morbidity and mortality in low and middle-income countries. Cancer registry figures help for planning and delivery of health services. This paper provided the first results of cancer incidence and mortality [Crude (CR) and age-standardized (ASR)] rates (world-standard population) of Trivandrum district, South India and compared with other registries under the network of National Cancer Registry Programme (NCRP), Government of India. Materials and Methods: Trivandrum district cancer registry encompasses a population of 3.3 million, compiles data from nearly 75 sources (hospitals and diagnostic laboratories) and included under the NCRP in 2012. During 2012-2014, registry recorded 15,649 incident cases and 5667 deaths. Proportion of microscopic diagnosis was 85% and ‘Death certificate only’ was 8%. Results: Total cancer incidence (CRs) rates were 161 and 154 (ASR: 142.2 and 126) and mortality rates were 66 and 49 (ASR: 54 and 37) per 105 males and females respectively. Common cancers in males were lung (ASR:19), oral cavity (ASR:15), colo-rectum (ASR:11.2), prostate (ASR:10.2) and lymphoma (ASR:7) and in females, breast (ASR:36), thyroid (ASR:13.4), cervix-uteri (ASR:7.3), ovary (ASR:7) and colo-rectum (ASR:7). Nationally, the highest CRs for breast, prostate, colo-rectum, corpus-uteri and urinary bladder cancers and low incidence of cervix-uteri cancer were observed in Trivandrum. Conclusion: Cancer incidence (CR) in Trivandrum was the highest in both genders in India (except Aizwal). This is mainly due to the highest life-expectancy in Kerala. Also, an epidemiologic transition in cancer pattern is taking place and is changing to more similar to "western" jurisdictions.     

Overview of the National Cancer Screening Programme and the Cancer Screening Status in Korea

Organised cancer screening in Korea began in 1999. Operating system has been stabilised, target populationhave expanded and participation rate has been increased throughout its ten years. Here we present an overviewof the organised cancer screening system in Korea and introduce the National Cancer Screening Programmeincluding results from 2002 to 2008. Furthermore, we present the results of the Korea National Cancer ScreeningSurvey, a survey that is representative of the population, from 2004 to 2009. Finally, we discuss our achievementsand the future challenges.     

Cancer Incidence in Saudi Arabia: 2012 Data from the Saudi Cancer Registry

Background: In order to most appropriately allocate healthcare and research funding for cancer, it is important to have accurate population-based incidence data. The Saudi Cancer Registry (SCR) provides such information, covering the time period from 1994 to the present day. The current report concerns an overview of cancer incidence statistics for Saudi Arabia in 2012. Methods: The SCR collects data from healthcare facilities throughout the Kingdom of Saudi Arabia. All newly diagnosed cases of cancer are recorded, with information on site and histology. For the present report, age-standardised and age-specific incidence rates (ASR, AIR, respectively) were calculated, with attention to gender-specific and regional differences. Results: The total number of incident cases of cancer identified by the SCR in 2012 was 14,336, with 6,791 (47.5%) among males and 7,545 (52.6%) among females. Of this total, 11,034 cases (76.9%) occurred in patients of Saudi origin. For Saudi males, the overall ASR (inc. all cancer sites) was 78.1 per 100,000 people, while that for females was 86.7. Incidence varied by region, with the Eastern region and Riyadh displaying the highest ASRs for both males and females, and Hail and Jazan displaying the lowest. Incidence varied by gender, with colorectal cancer (13.3%), non-Hodgkin lymphoma (NHL; 8.4%), and leukaemia (8.2%) being the most common types in males, and breast (25.8%), thyroid (11.7%), and colorectal cancers (9.3%) being the most common in females. Conclusions: This analysis of cancer incidence in Saudi Arabia demonstrated significant differences according to gender, age, and region of the Kingdom. The data should help ensure the most appropriate allocation of resources, with the aim of minimising the healthcare burden associated with cancer.     

Cancer Incidence and Mortality in Central Myanmar: Report of Nay Pyi Taw Population-Based Cancer Registry

Background: Cancer is a major public health problem in Myanmar, and cancer registration activities are currently underway through both hospital-based and population-based approaches. So far, there are no population-based cancer incidence and mortality estimates in the country. Methods: According to the 2014 census, the total population of Nay Pyi Taw Union Territory was 1,160,242 within the area of 70,571 km2. Nay Pyi Taw Cancer Registry team collected data of new cancer cases both actively and passively from all data sources in the region. The data were registered, updated, cross-checked, quality-assured, and analyzed in CanReg5. The results were presented as the number of cases by site, sex, and age, cumulative risk (CR), crude rate, age-specific, and age-standardized incidence rates (ASRs) per 100,000. Results: Total 5,952 new cancer cases and 1874 cancer deaths were recorded among the population of the Nay Pyi Taw Union Territory between 2013 and 2017. The age-standardized incidence rate for all cancer sites excluding non-melanoma skin cancers in males was 125.9 and 107.3 for females. For both sexes combined, the most common cancers were lung (14%), breast (11.4%), liver (10.2%), mouth and pharynx (8.5%), and stomach cancers (7.8%). In males, the most common were lung (18.1%), liver (14.8%), mouth and pharynx (13%), stomach (8.9%) and colon, rectum, and anus (7.4%) cancers. In females, these were breast (21.2%), cervix (13.0%), lung (10.3%), stomach (6.9%) and colon, rectum, and anus (6.3%) cancers. The most common cancer deaths were caused by liver (20.8%), lung (15.7%), mouth and pharynx (9.3%), stomach (7.5%), and Colon, rectum, and anus (6.8%) cancers. Conclusion: The findings in this study are salient and have potential to serve as important information for the National Cancer Control Program to formulate prevention and control strategies.     

Feasibility of Establishing an Artificial Intelligence Based Head and Neck Cancer Registry: Experience from a Tertiary Care Hospital

Introduction Establishing and maintaining a cancer registry in a tertiary high volume centre is fraught with difficulty, inaccuracy and missed data entry. Further, the raw unstructured data must be converted into a structured digital data, so that scientists can identify trends in cancer diagnoses and treatment responses. Objective We test the feasibility of establishing a cancer registry of Head and Neck malignancy patients through a research oriented artificial intelligence (AI) enabled data collection platform, using its smartphone application version. Materials and Methods This prospective observational study was conducted in the Department of Otolaryngology & Head and Neck Surgery, Post Graduate Institute of Medical Education And Research, Chandigarh in collaboration with Departments of Radiotherapy and Community Medicine. After taking due clearance from the Institute ethical committee, HNC patients, who were biopsy proven, were enrolled from October 2019 up to March 2021. The obtained data was entered, followed up and analysed through Jiyyo Research application which is a commercially available dedicated research oriented AI enabled data collection platform. Results The Jiyyo Research site was browsed and after proper registration, the patient data was entered into a proforma/questionnaire. The entered patient details were browsed for review, follow up and addition of new information. The whole process of data capture for each patient, took approximately 5-8 min, while any updates or review for the same patient required less than a minute. Search and data retrieval was very quick, and can be done in 1-2 min. Through this platform, a total of 1214 HNC patients were collected, followed and analysed during the study period. Conclusion It was feasible to establish a Head and Neck Cancer Registry using an AI based smartphone app. This AI based tumor registry could benefit in further studies with longer follow up of 5 and 10 years and in future AI studies.Supplementary InformationThe online version contains supplementary material available at 10.1007/s12070-022-03173-3.     

Colorectal Cancer in Brunei Darussalam: An Overview and Rationale for National Screening Programme

Colorectal cancer (CRC) is the third most common cancer worldwide after lung and breast cancers, and ranks second in terms of cancer mortality globally. Brunei Darussalam reports high incidence of CRC in the Southeast Asian region and has no formal national screening programme for CRC. Screening for CRC in Brunei Darussalam is offered in an opportunistic fashion for individuals with average or above average risks for CRC, that is, the individual has a positive family history of CRC or neoplasms and is more than 50 years old. Opportunistic screening is widely practiced but this is not standardised. The Ministry of Health in Brunei Darussalam is currently in the process of implementing a CRC screening programme as part of a larger national health screening based on the increasing incidence of non-communicable diseases (NCDs). This review article assesses the situation of CRC in Brunei Darussalam from the 1980s to present day, including incidence of CRC in different age groups, ethnicities and genders; relevant non-modifiable and modifiable risk factors of CRC in Brunei Darussalam setting; and common CRC screening techniques used in Brunei Darussalam as well as other Asia-Pacific countries. The review also discusses the merits of a national CRC screening programme. With the increasing incidence of CRC worldwide and in Brunei Darussalam, national screening for CRC in Brunei Darussalam is an important strategy to lower morbidity and mortality rates. A review of the progress and outcome of the national screening programme will be available a few years after rollout.     

Disparities in Compliance with Colorectal Cancer Screening: Evidence from Two US National Surveys

Objective: Colorectal cancer (CRC) is the most preventable cancer if adherence to its screening guidelines through compliance with physician recommendations are met. Lack of access to care is the most significant barrier which was decreased by the Affordable Care Act (ACA), that may influence healthcare behaviors/practices. The aim of this study was to determine the factors affecting compliance with recommendations for CRC screening between two US National Health Interview Surveys (NHIS) in 2010 and 2015. Methods: We used individual data of adults aged ≥50 years from the Cancer Module of NHIS that repeats every-5-years. Multiple logistic regression analyses were employed to identify the compliance associated factors and their changes after five years. Results: We included final data of 1,553 and 2259 and individual from 2010 and 2015, respectively. Overall, compliance to physician recommendations for colorectal cancer was 85.70% in 2010 and 81.54%. Men compiled more in 2010 than women which was reversed in 2015. The multivariable-adjusted odds of compliance were increased with age; lower for female [Odds ratio (OR)= 0.45 Confidence Interval (CI 95% 0.27, 0.75), having a family history of CRC [OR=3.05 CI:1.02, 9.05], having insurance [OR 3.58 CI:1.4, 9.12], and Odds increased with the number of doctor visit in 2010. However, in 2015 the odds were substantially increased with the increasing age, reversed odds for female [OR= 3.49 CI: 1.67, 7.29)], increased for non-Hispanic Blacks [OR= 4.87 CI: 2.05, 11.55] and lower for Asian [OR=0.33 CI:0.15, 0.74], higher for family history of colorectal cancer [OR=3.31 CI:1.92, 5.69]. Although insurance coverage and the number of doctor visits were significant predictors of compliance in 2010, those became non-significant in 2015. Conclusions: Compliance disparities by gender and access to healthcare either reduced in strength or reversed between 2010 and 2015. The non-Hispanic Black significantly higher in compliance than other race-ethnicities in 2015.     

Improvement in the Treatment of Childhood Cancer: Analysis of Survival Data from the National Children's Hospital (1965-1987)

Developments in the treatment of childhood cancer have beenevaluated in patients who had been treated in the National Children'sHospital from 1965 to 1987. The total number of patients was867, of which leukemia accounted for 376, malignant lymphoma61, neuroblastoma 174, Wilms' tumor 55, yolk sac tumor 29, rhabdomyosarcoma36 and hepatoblastoma 30. Patients were divided into three timeintervals: the 1960s, 1970s and 1980s. A marked improvementin five-year survival was recognized in Wilms' tumor and yolksac tumor, amounting to 80%, followed by rhabdomyosarcoma, acutelymphoblastic leukemia and malignant lymphoma. There was noimprovement in patients with acute non-lymphoblastic leukemia,neuroblastoma and hepatoblastoma. Prognostic factors for neuroblastomawere further analyzed, and the age of onset and stage of diseasewere found to have remained constant for 23 years. Factors relatingto the improvement of survival were discussed.     

Descriptive Epidemiology of Female Breast Cancer in Delhi,India

Background: Breast cancer is the most frequently diagnosed cancer in females worldwide. The Population Based Cancer Registry data of Delhi were here used to describe the epidemiology and trends in breast cancer incidence in Delhi. Methods: Crude rate, age-standardized incidence rates (ASR) and age-specific incidence rates were calculated using the data collected by Delhi PBCR for the year 2012. The time trend of breast cancer incidence was evaluated by joinpoint regression using the PBCR data from 1988-2012. Results: A total of 19,746 cancer cases were registered in 2012, 10,148 in males and 9,598 in females. Breast cancer was the leading site of cancer in females accounting for 2,744 (28.6%) of cases with a median age of 50 years. The crude and age standardized incidence rates for breast cancer were 34.8 and 41.0 per 100,000 females, respectively. Age specific incidence rates increased with age and attained a peak in the 70-74 years age group..A statistically significant increase in ASR with an annual percentage change (APC) of 1.44% was observed. Conclusions: The breast, which was the second most common cancer site in Delhi in 1988, has now surpassed cancer of cervix to become the leading site over the years. A similar trend has also been noted for other metropolitan cities viz. Bangalore, Bhopal and Chennai. Though the ASRs in these are comparable, they are still low compared to Western countries. Changing life styles in metropolitan cities like delayed marriage, late age at first child birth, lower parity and higher socio-economic status, may be some of the probable primary cause for higher incidences of breast cancer in urban as opposed to rural areas.     

Lung cancer prognostic factors from the Aichi Cancer Registry

Lung cancer prognostic factors have been evaluated on the basis of three-year survival rates for 2,830 lung cancer patients diagnosed between 1983 and 1986 and reported to the Aichi Cancer Registry. In the univariate analyses, the former in each pair of following factors showed a significantly better prognosis than the latter: early vs. late stage of disease, surgically-treated vs. non-surgically-treated cases, adenocarcinoma and squamous cell carcinoma vs. large cell and small cell carcinoma, cases detected by screening vs. others, young vs. old patients, females vs. males, non-smokers vs. smokers. The association of prognosis with these factors, other than smoking and histological type, remained statistically significant throughout multivariate analysis. When analyzed according to histological type, disease stage was the most important prognostic factor, across all histological types, and surgery was the second most important prognostic factor, except in cases of small cell carcinoma. Sex and method of detection were significantly associated with survival rates in adenocarcinoma and small cell carcinoma, and the association with smoking was of borderline significance for adenocarcinoma.     

Trends in Lung Cancer Incidence in Delhi,India 1988-2012: Age-Period-Cohort and Joinpoint Analyses

Introduction: Lung cancer (LC) has been one of the most commonly diagnosed cancers worldwide, both in termsof new cases and mortality. Exponential growth of economic and industrial activities in recent decades in the Delhiurban area may have increased the incidence of LC. The primary objective of this study was to evaluate the time trendaccording to gender. Method: LC incidence data over 25 years were obtained from the population based urban Delhicancer registry. Joinpoint regression analysis was applied for evaluating the time trend of age-standardized incidencerates. The age-period-cohort (APC) model was employed using Poisson distribution with a log link function and theintrinsic estimator method. Results: During the 25 years, 13,489 male and 3,259 female LC cases were registered,accounting for 9.78% of male and 2.53% of female total cancer cases. Joinpoint regression analysis revealed that LCincidence in males continued to increase during the entire period, a sharp acceleration being observed starting from2009. In females the LC incidence rate remained a plateau during 1988-2002 and thereafter increased. The cumulativerisks for 1988-2012 were 1.79% and 0.45%. The full APC (IE) model showed best fit for an age-period-cohort effecton LC incidence, with significant increase with age peaking at 70-74 years in males and 65-69 years in females. Arising period effect was observed after adjusting for age and cohort effects in both genders and a declining cohort effectwas identified after controlling for age and period effects. Conclusion: The incidence of LC in urban Delhi showedincreasing trend from 1988-2012. Known factors such as environmental conservation, tobacco control, physical activityawareness and medical security should be implemented more vigorously over the long term in our population.     

Patterns and Trends with Cancer Incidence and Mortality Rates Reported by the China National Cancer Registry

National cancer registration reports provide a huge potential for identifying patterns and trends of important policy, research, prevention and treatment significance. As summary reports written on an annual basis, the China Cancer Registry Annual Reports (CCRARs) fall short from fully addressing their potential. This paper attempts to explore part of the patterns and trends hidden behind published CCRARs. It extracted data for cancer incidence rates (IRs) and mortality rates (MRs) for 2004, 2006 and 2009 from relevant CCRARs and portrayed 4 kinds of indicators in line graphs. The study showed that: a) all of the line graphs of age-specific IRs and MRs characterized typical “growth curves or histogram”; b) graphs of IRs and MRs for males and urban areas had higher peaks than that for females and rural regions; c) most of the line graphs of IR/MR ratios comprised a starting peak, a secondary peak and a decreasing tail and the secondary peaks for females and urban areas were higher than those for males and rural areas; d) most of the urban versus rural IR ratios valued above one, but most the urban versus rural MR ratios, below one; e) the accumulative IRs and MRs showed a stable increasing trend from 2004 to 2009 for urban areas, but mixed for rural regions.     

Lung Cancer Screening Registry Reveals Low-dose CT Screening Remains Heavily Underutilized

BackgroundSince 2013, the United States Preventive Services Task Force has recommended annual screening for lung cancer in high-risk patients with low-dose computed tomography (LDCT). Current literature has provided estimates of the lung cancer screening rate and only prior to appropriate insurance coverage for LDCTs. The aim of this study was to use newly established registry data to assess the lung cancer screening rate across the United States.Materials and MethodsUsing data from the Lung Cancer Screening Registry provided by the American College of Radiology in 2016, we collected the total number of LDCT screens performed from all 1962 accredited radiographic screening sites. The 2015 National Health Interview Survey was used to estimate screening eligible smokers per United States Preventive Services Task Force criteria. These data were compared to calculate screening rate.ResultsIn 2016, 2.0% of 7.6 million eligible smokers were screened. Rates varied by region from 1.1% in the West to 3.9% in the Northeast. The South consisted of 40.4% of eligible smokers and the most accredited screening sites (37%); however, their screening rate was among the lowest (1.7%) in the nation. Smoking cessation counseling was offered to 84% of screened current smokers prior to receiving LDCTs.ConclusionsLung cancer screening remains heavily underutilized despite guideline recommendation since 2013, insurance coverage, and its potential to prevent thousands of lung cancer deaths annually.